Traumatic rupture of an aberrant right subclavian artery.

We describe a patient who sustained a traumatic rupture of an aberrant right subclavian artery. An interposition graft was used to restore continuity of the artery to the descending thoracic aorta.

Bilateral abdominoscrotal hydrocele: a case report.

A 13-month-old boy, who had been diagnosed in utero as having bilateral hydroceles, was found to have bilateral abdominoscrotal hydroceles. To date, there has been only one previous case of bilateral abdominoscrotal hydroceles in an infant. Magnetic resonance imaging was used to make the diagnosis: bilateral dumbell shaped fluid filled masses were seen in a coronal image. The patient had the abdominoscrotal hydroceles excised through bilateral groin incisions. The postoperative course was uneventful, without complication. The etiology and diagnosis of abdominoscrotal hydroceles are discussed.

Aortic dissection: rupture into right ventricle and right pulmonary artery.

Rupture of an acute ascending aortic dissection into a surrounding cardiac chamber or pulmonary artery is an uncommon occurrence, and is often only diagnoses post mortem. Although fistulization (aortopulmonary and aorta-right atrial) after acute aortic dissection has been well documented in the literature, acute aortic dissection fistulizing into both the right ventricle and pulmonary artery has not. We report on a 75-year-old woman who presented with an acute ascending aortic dissection with both aortopulmonary and aorta-right ventricular fistulas who underwent repair and had long-term survival.

A prospective randomized comparison of Dacron and polytetrafluoroethylene aortic bifurcation grafts.

BACKGROUND: The purpose of this study was to compare the long-term results of Dacron and polytetrafluoroethylene (PTFE) aortic bifurcation grafts in a prospective randomized manner. METHODS: Sixty patients with aortoiliac occlusive disease were randomized to receive Dacron or PTFE bifurcation grafts. Preoperative risk factors, perioperative blood loss and fluid requirements, and postoperative complications were compared. A mean follow-up of 57 months was achieved. RESULTS: The immediate postoperative morbidity and mortality rates were similar in the two groups, and the long-term complications were low in number and comparable. The cumulative patency rate for Dacron graft limbs was 86% versus 95% for PTFE graft limbs. CONCLUSIONS: No significant differences were noted between the results achieved with Dacron and PTFE aortic bifurcation grafts.

Entrapment of small bowel after laparoscopic herniorrhaphy.

As laparoscopic hernia repair continues to evolve as an operative procedure, papers will continue to be published discussing new variations and new techniques which will better the operative procedure as a whole and quite possibly decrease its associated complications (i.e., morbidity and mortality). We present a case of laparoscopic bilateral herniorrhaphy in which after uncomplicated surgery and an immediate, uneventful postoperative course, the patient returned to our institution with both a rectus sheath hematoma and small bowel obstruction. The patient, who was initially treated conservatively, ultimately required laparotomy for persistent small bowel obstruction. Laparotomy revealed incarcerated small bowel in a cavity between the posterior rectus fascia and the rectus muscle proper. The patient did well after laparotomy and was discharged home with no further complications.